Oral Background

Tablets and Other Dosage Forms*

Welcome to ViiVConnect. We have
programs for eligible
patients who are
insured, underinsured, and uninsured.

Photography is being used for illustrative purposes only. Stock photo. Posed by model.

How to Enroll for Tablets and Other Dosage Forms*

Complete the
ViiVConnect Enrollment Form

Complete the ViiVConnect Enrollment Form

Healthcare Professionals, Pharmacists, and Patient Representatives may register in the ViiVConnect Portal to assist their patients with the ViiVConnect enrollment process for prescribed ViiV medicines.

Enrollment in the ViiVConnect Portal is not required for patients to access their prescribed ViiV Healthcare medicines.

For Healthcare Professionals, Pharmacists, and Patient
Representatives Only

Submit the
ViiVConnect Enrollment Form

Submit the ViiVConnect Enrollment Form

FAX: 1-844-208-7676

MAIL: ViiVConnect Enrollment
PO Box 220100
Charlotte, NC 28222-0100

ENROLL BY PHONE:
Call our live Access Coordinator
team to enroll patients over the
phone at 1-844-588-3288 (toll free)

ENROLL ONLINE:
Healthcare Professionals, Pharmacists, and
Patient Representatives can electronically
enroll patients on the ViiVConnect Portal.

For Healthcare Professionals, Pharmacists, and Patient
Representatives Only

An Access Coordinator may contact you regarding insurance coverage for prescribed ViiV medicines and eligibility for ViiVConnect programs.

An Access Coordinator may contact you regarding insurance coverage for prescribed ViiV medicines and eligibility for ViiVConnect programs.

*Other ViiV Healthcare medicines include: tablets, oral solutions, an oral suspension, capsules, syrup, and an injection, for intravenous use.

A patient signature is required to enroll into ViiVConnect programs. If you are unable to manually sign, use this link to authorize an electronic signature if an enrollment form was submitted previously without one.

ViiVConnect Programs

The ViiV Healthcare Patient Assistance Program offers our medicines at no cost to patients who qualify. 

The ViiVConnect Savings Card 
Potential savings for your ViiV Healthcare prescription medicines.

Subject to eligibility, program terms and conditions. ViiVConnect programs do not constitute health insurance.

NEED HELP? TALK ONE-ON-ONE LIVE WITH OUR ACCESS COORDINATORS   
1-844-588-3288 (toll free)

We have programs for eligible patients who are insured, underinsured, and uninsured. 
Monday - Friday, 8AM - 11PM (ET).
Multilingual options available.

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